Pacemakers Flashcards
External (transcutaneous) pacemaker
- energy is deliver transcutaneously through the thoracic musculature to the heart via two electrode patches placed on the skin
- requires large amount of electricity, which can be painful
- used only in emergency resuscitation of a client who does not have pacing wires inserted
Epicardial
- pacemaker leads are attached directly to the heart during open-heart surgery
- wires run externally through the chest incision and may be attached to an external impulse generator if needed
-commonly used during and immediately following open-heart surgery
Endocardial (transvenous)
-pacing wires are threaded through a large central vein (subclavian, jugular, or femoral) and lodged into the wall of the right ventricle (ventricle pacing), right atrium (atrium pacing) , or both chambers (dual chamber pacing)
Permanent pacemakers
- indicated for chronic recurrent dysrhythmias due to sinus or atrioventricular node malfunction
- can be programmed to pace the atrial (a) or ventricular (v) chamber, or both (Av)
Pacemaker modes
- fixed rate (asynchronous)
- demand mode (synchronous)
- tachydysrhythmia function
Fixed rate (asynchronous)
Fired at a constant rate without regard for the hears electrical activity
Demand mode (synchronous)
Detects the hearts electrical impulse and fires at a preset rate only if the hearts intrinsic rate is below a certain level.
Modes:
Inhibited: pacemaker activity is inhibited/does not fire
Triggered: pacemaker activity is triggered/fires when intrinsic activity is sensed
Tachydysrhythmias function
Can overpace a tachydysrhythmia and/or deliver an electrical shock
Discharge teaching
- carry pacemaker id
- no raising arm above head for 1-2 weeks
- take pulse daily/ notify dr. If heart rate is less than 5 beats below the pacemaker rate
- report dizziness, fatigue, weakened
